It is common in the surgical field to close skin wounds by passing a suture through the skin in order to approximate the edges of the skin and hold it stiched in place for healing. Suturing or stiching technics allow the physician to adjust tension, and thus permit approximation on a stich by stich basis. These technics however suffer from various disadvantages. They are labor intensive, time consuming and require manual dexterity on the part of the physician in order to close the wound in such a manner as to minimize scarring. The suturing technics also conventionally require removal of the stiches, thus usually necessitating an additional visit to the physician.
In an effort to reduce the time and labor required for suturing, many medical surgeons have turned to the use of surgical staples. The art of surgical staples is replete with devices and designs of staples and staple appliers. Such devices have now been widely accepted by the medical profession.
While efficient in reducing the time and effort required to close a given wound, the surgical staples suffer from a series of drawbacks. One major disadvantage associated with the use of surgical staples is the formation on the skin of the patient of unesthetical tranversal line marks extending across the suture line. These lines, often referred to as "railway pattern" marks, are mostly imputable to a strangulation by the staples of the connective fibroelastic tissue making up the dermic layer of the skin. Indeed, the swelling of the scarring area causes the elastic fibers of the dermic layer to be pushed against the relatively stiff staples, thus strangeling the fibers.
To minimize this problem, some physicians have resorted to removing the staples after a relatively short period of time. Although helpful in reducing the amount of damage caused to the fibers of the dermic layer, this practice creates a potential risk of dehiscence since the maximal resistance of the wound to tensile stress is only reached after a period of approximately three weeks of recovery.
Another drawback of using suture threads or metal clips on the outside of the skin is that the skin edge portions held together will not be fully accessible for inspection and cleaning, if necessary. They also prevent, at least partially, free "breathing" at the site of the closed incision.